| NPI | 1144716598 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: AR E-15391) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: OK 6772) |
| Enumeration Date | 2018-07-09 |
| Last Update Date | 2022-06-08 |